从肺移植前到肺移植后的食道功能测试中,吞失败的增加与急性排斥有关
Wai-Kit Lo1, Pranay Nadella2, Natan Feldman1
1Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital, Boston, MA 02115, United States.
World journal of transplantation
|December 8, 2025
概括
肺移植后食道下移性增加与急性细胞排斥 (ACR) 的更高率有关. 这一发现表明,常规的食道功能测试可以识别肺移植接受者,他们面临着不良结果的风险.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 胃肠病学 胃肠病学
背景情况:
- 胃食道逆流性疾病 (GERD) 的病理生理学及其与不良肺移植结果的联系尚未完全理解.
- 肺移植可能会改变食道功能,影响反流风险和移植后的结果.
- 移植后食道功能变化的对排斥风险的影响尚不清楚.
研究的目的:
- 研究肺移植前后食道运动变化与急性细胞排斥 (ACR) 风险之间的关联.
主要方法:
- 55名肺移植接受者进行了移植前和移植后高分辨率计量 (HRM) 的回顾性队列研究.
- 急性细胞排斥 (ACR) 根据国际心脏和肺移植学会的标准定义.
- 使用多变量Cox比例危险模型和Kaplan-Meier分析来评估结果.
主要成果:
- 移植后吞失败的增加与较低的基线肺总容量 (TLC) 和较差的食道玻尿酸清除相关.
- 移植后食道低运动独立预测增加的ACR (HR: 3.62,P = 0.03).
- 在移植后吞失败增加的患者中观察到更高的ACR率 (P = 0.048).
结论:
- 消化管低流动性,以HRM上的失败吞增加为指标,与肺移植后的ACR独立相关.
- 较低的基线TLC表明限制性肺病可能与移植后的食道低移动性有关.
- 常规的食道功能测试可以确定肺移植接受者有更高的排斥和不良结果风险.
相关概念视频
Kidney Transplant III: Nursing Management
294
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
294
Gastroesophageal Reflux Disease II: Clinical Features and Management
662
Gastroesophageal reflux disease, or GERD, is a persistent medical condition that affects many individuals worldwide. Its clinical manifestations can vary greatly, making diagnosis and management challenging for healthcare professionals. The following is a comprehensive overview of the clinical manifestations, assessment, and management strategies for GERD.
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
662
Esophageal Strictures-II: Clinical Features and Management
393
Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
393
Acute Respiratory Failure-V
425
The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Ensure that patients are monitored continuously for their response to therapy, including changes in...
425
Barrett Esophagus-II: Clinical Manifestations and Management
743
Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
743
Upper GI Series: Barium Swallow
1.4K
The Barium Swallow Study, or a Barium Esophagogram, is a diagnostic imaging method used to visualize the upper gastrointestinal (GI) tract, including the esophagus, stomach, and small intestine. It employs barium sulfate, a radiopaque contrast material, to provide clear images of the upper digestive system, helping to identify abnormalities, diseases, or structural issues.
Purpose and Procedure
Patients undergoing this procedure ingest a liquid containing barium sulfate with a chalky...
Purpose and Procedure
Patients undergoing this procedure ingest a liquid containing barium sulfate with a chalky...
1.4K


